This is performed for vaginal prolapse of the bladder and/or apex of the vagina. Under general anesthesia, the patient is placed in the lithotomy position (with legs in stirrups) and the entire surgery is performed vaginally, with no abdominal incisions. The vaginal tissue is separated from the bladder wall and permanent mesh is placed behind the bladder for support. It is attached to the sacrospinous ligament (a ligament in the pelvis) using mesh arms. The vaginal tissue is closed using a stitch that will dissolve. The procedure takes approximately 45 minutes to complete. You will be in the hospital overnight with a gauze vaginal packing and catheter draining the bladder. Both of those will be removed the morning after surgery and you will be asked to void prior to discharge. If you are unable to void then you may be discharged to home with a catheter draining to a bag that will be removed in one week. There is no prep for the procedure. For 6 weeks post op you will be asked to have no straining, no lifting over 20 pounds and no sex or tampons in the vagina. Most women feel back to normal after approximately 2 weeks.